@layout("/common/_container.html"){
<link href="${ctxPath}/static/css/shop/shopcustomer.css?v=20200718" rel="stylesheet">
<div class="ibox float-e-margins" id="customerInfoForm">
    <div style="display: none">
        <input type="hidden" id="id" value="${id}">
        <input type="hidden" id="provinceValue" value="${province}">
        <input type="hidden" id="citiesValue" value="${cities}">
        <input type="hidden" id="regionValue" value="">
        <input type="hidden" id="oneChannelValue" value="${oneChannel}">
        <input type="hidden" id="twoChannelValue" value="${twoChannel}">
        <input type="hidden" id="thrChannelValue" value="${thrChannel}">
        <input type="hidden" id="oneMediumValue" value="${oneMedium}">
        <input type="hidden" id="twoMediumValue" value="${twoMedium}">
        <input type="hidden" id="thrMediumValue" value="${thrMedium}">
        <input type="hidden" id="Recommender" value="">
        <input type="hidden" id="fieldTcValue" value="">
    </div>
    <div class="matchingPatient">
        <div style="background: #415472;color: white;padding: 5px 10px;">新建到店患者(一号多人)</div>
        <div style="height: calc(100% - 77px);overflow:auto;padding: 0 20px 20px;">
            <div class="requiredData">
                <div class="requiredTitle"><h4>必填选项</h4></div>
                <div class="requiredContent">
                    <div class="fill-item-box">
                        <div class="fill-item">
                            <div class="fill-item-title"><span>姓名 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="customerName" class="frameBox"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>生日 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="birthday" class="frameBox" maxlength="10"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>年龄 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="customerAge" maxlength="2" class="frameBox" oninput="value=value.replace(/[^\d]/g,'')"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>性别 <span class="must">*</span></span></div>
                            <div class="fill-item-content">
                                <select name="customerSex" id="customerSex" class="frameBox">
                                    <option value="1">男</option>
                                    <option value="2">女</option>
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>科室 <span class="must">*</span></span></div>
                            <div class="fill-item-content">
                                <select id="treatmentUnit" class="frameBox">
                                    <option value="待定">待定</option>
                                    @for(str in departmentList){
                                    <option value="${str.department}">${str.department}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>分诊TC <span class="must">*</span></span></div>
                            <div class="fill-item-content">
                                <select name="fieldTc" id="fieldTc" class="frameBox">
                                    <option value="待定TC">待定TC</option>
                                    @for(str in tcList){
                                    <option value="${str.tcName}">${str.tcName}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>导医 <span class="must">*</span></span></div>
                            <div class="fill-item-content">
                                <select name="guideDoctor" id="guideDoctor" class="frameBox">
                                    <option value="">请选择</option>
                                    @for(str in guideDoctorList){
                                    <option value="${str.guideDoctor}">${str.guideDoctor}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>建档人 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="archiving" class="frameBox" value="${userName}" readonly="readonly"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>推荐人</span></div>
                            <div class="fill-item-content">
                                <input autocomplete="off" type="text" id="referee" class="frameBox" readonly="readonly" style="width: 54%;background: #eaeae3" >
                                <button class="btn btn-special" type="button" onclick="CustomerInfoDlg.getReferee()">选择</button>
                            </div>
                        </div>
                    </div>
                    <div class="fill-item-box">
                        <div class="fill-item">
                            <div class="fill-item-title"><span>电话 <span class="must">*</span></span></div>
                            <div class="fill-item-content">
                                <input autocomplete="off" type="text" id="customerPhone" class="frameBox" value="${customerPhone}" readonly="readonly" style="width: 50%">
                                <select class="frameBox" style="width: 28%" id="phoneSharShip">
                                    @for(str in refereeShipList){
                                    <option value="${str.refereeShip}">${str.refereeShip}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>一级渠道 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><select name="oneChannel" id="oneChannel" class="frameBox"></select></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>二级渠道 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><select name="twoChannel" id="twoChannel" class="frameBox"></select></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>三级渠道 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><select name="thrChannel" id="thrChannel" class="frameBox"></select></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>一级媒介 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><select name="oneMedium" id="oneMedium" class="frameBox"></select></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>二级媒介 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><select name="twoMedium" id="twoMedium" class="frameBox"></select></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>三级媒介 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><select name="thrMedium" id="thrMedium" class="frameBox"></select></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>推荐关系</span></div>
                            <div class="fill-item-content">
                                <select name="refereeShip" id="refereeShip" class="frameBox">
                                    <option value="">--请选择关系--</option>
                                    @for(str in refereeShipList){
                                    <option value="${str.refereeShip}">${str.refereeShip}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                    </div>
                    <div class="fill-item-box">
                        <div class="fill-item">
                            <div class="fill-item-title"><span>客户状态 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="customerStatus" disabled="disabled" class="frameBox" value="新客首次"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>省份 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><select name="province" id="province" class="frameBox"></select></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>城市 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><select name="cities" id="cities" class="frameBox"></select></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>区域</span></div>
                            <div class="fill-item-content"><select name="region" id="region" class="frameBox"></select></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>地址</span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="address" class="frameBox"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>黄页编号 <span class="must">*</span></span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" class="frameBox" id="yellowNumber" name="yellowNumber" oninput="value=value.replace(/[^\d]/g,'')"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>职业</span></div>
                            <div class="fill-item-content">
                                <select name="occupation" id="occupation" class="frameBox">
                                    <option value="其他">其他</option>
                                    @for(str in occupationList){
                                    <option value="${str.occupation}">${str.occupation}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>输入卡号</span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="cardNumber"  class="frameBox"></div>
                        </div>
                    </div>
                </div>
            </div>
            <div class="chooseData">
                <div class="chooseTitle"><h4>选填选项</h4></div>
                <div class="chooseContent">
                    <div class="fill-item-box">
                        <div class="fill-item">
                            <div class="fill-item-title"><span>消费能力</span></div>
                            <div class="fill-item-content">
                                <select name="consumAbility" id="consumAbility" class="frameBox">
                                    <option value="">--请选择消费能力--</option>
                                    @for(str in consumAbilityList){
                                    <option value="${str.consumAbility}">${str.consumAbility}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>消费习惯</span></div>
                            <div class="fill-item-content">
                                <select name="consumptionHabits" id="consumptionHabits" class="frameBox">
                                    <option value="">--请选择消费习惯--</option>
                                    @for(str in consumptionHabitsList){
                                    <option value="${str.consumptionHabits}">${str.consumptionHabits}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>身份证</span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="idCardNo" class="frameBox"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>座机</span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="fixedTelephone" class="frameBox" oninput="value=value.replace(/[^\d]/g,'')"></div>
                        </div>
                    </div>
                    <div class="fill-item-box">
                        <div class="fill-item">
                            <div class="fill-item-title"><span>QQ号</span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="qqNumber" class="frameBox" oninput="value=value.replace(/[^\d]/g,'')"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>微信号</span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="wechatNumber" class="frameBox"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>Email</span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="email" class="frameBox"></div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>邮编</span></div>
                            <div class="fill-item-content"><input autocomplete="off" type="text" id="zipCode" class="frameBox" oninput="value=value.replace(/[^\d]/g,'')"></div>
                        </div>
                    </div>
                    <div class="fill-item-box">
                        <div class="fill-item">
                            <div class="fill-item-title"><span>婚姻状况</span></div>
                            <div class="fill-item-content">
                                <select name="maritalStatus" id="maritalStatus" class="frameBox">
                                    <option value="0">请选择</option>
                                    <option value="1">已婚</option>
                                    <option value="2">未婚</option>
                                    <option value="3">离异</option>
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>有无小孩</span></div>
                            <div class="fill-item-content">
                                <select name="isHaveChildren" id="isHaveChildren" class="frameBox">
                                    <option value="0">请选择</option>
                                    <option value="1">有</option>
                                    <option value="2">无</option>
                                </select>
                            </div>
                        </div>
                        <div class="fill-item">
                            <div class="fill-item-title"><span>性格</span></div>
                            <div class="fill-item-content">
                                <select name="characters" id="characters" class="frameBox">
                                    <option value="">--请选择性格--</option>
                                    @for(str in charactersList){
                                    <option value="${str.characters}">${str.characters}</option>
                                    @}
                                </select>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
            <div class="remarksData">
                <div class="remarksTitle"><h4>备注</h4></div>
                <div class="remarksContent">
                    <textarea id="remarks" name="remarks" rows=5 style="width: 100%;margin-top: 5px"></textarea>
                </div>
            </div>
        </div>
        <div class="btnBox">
            <button type="button" class="btn" id="ensure" onclick="CustomerInfoDlg.addOnemuchCustomerSubmit()">提交</button>
            <button type="button" class="btn" id="cancel" onclick="CustomerInfoDlg.close()">取消</button>
        </div>
    </div>
</div>
<script src="https://pynnn.oss-cn-hangzhou.aliyuncs.com/jsAddresss.js?v=20200718"></script>
<script src="https://pynnn.oss-cn-hangzhou.aliyuncs.com/jsChannel.js?v=20200718"></script>
<script src="https://pynnn.oss-cn-hangzhou.aliyuncs.com/jsMedium.js?v=20200718"></script>
<script src="${ctxPath}/static/modular/arrival/customer/customer_receptionFor.js?v=20200718"></script>
<script src="${ctxPath}/static/modular/arrival/customer/customer_info.js?v=20200718"></script>
@}